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Immune Mediated Hemolytic Anemia (IMHA) – A Silent Killer

What are the Symptoms?

The syptoms of IMHA vary from dog to dog. One dog might exhibit some syptoms and not others.

Some of the symptoms include:

  • lethargy
  • jaundice
  • greying of the guns and/or tongue
  • irregular breathing
  • irregular heartbeat
  • loss of appetite
  • pale/yellow/grey skin
  • dark yellow urine

AIHA and IMHA are such dreadful diseases, no pet guardian should have to experience these conditions alone. These are the known causes of immune mediated hemolytic anemia (IMHA) that I know of:

Drugs that might induce IMHA: sulfonamides cephalosporins penicillins methimazole procainamide

A higher incidence of IMHA is seen in dogs within a month of vaccinations so it is presumed at the present time that some dogs react to vaccination by developing IMHA.

Metastatic cancer, especially hemangiosarcoma, is a common cause of IMHA in older dogs.

Tick borne illnesses, usually ehrlichiosis but possibly Rocky Mountain spotted fever and Lyme disease can lead to IMHA.

Severe bacterial infections (sepsis, for example) and some viral illnesses (more common in cats) can lead to IMHA.

  • 50% of dogs die within two weeks of diagnoses
  • The mortality rate is up to 80%

Please don’t wait any longer to take action. A dog’s condition can change in as little as 4 hours.

Immune Mediated Hemolytic Anemia (IMHA) or Auto-Immune Hemolytic Anemia (AIHA) appear to be the same disease with different names. Prednisone and Prednisolone are the most commonly prescribed drugs and while they do suppress the body’s immune system from attacking itself, they do nothing to regenerate the red blood cells that are being destroyed, resulting in anemia. When red blood cells are not manufactured at the bone marrow level, frequent blood transfusions are needed and this disease is often fatal. Immune Mediated Hemolytic Anemia (IMHA) or Auto-Immune Hemolytic Anemia (AIHA) have a very high fatality rate (nearly 50-80%). Some vets are seeing the onset of this auto-immune disease shortly after vaccinations.  In Dr. Jean Hofve’s article on Vaccination she states:

Several known risks are associated with one or more specific vaccines. Antibodies are the goal of vaccination. We want the body to produce antibodies against the disease being vaccinated against. However, the vaccine manufacturing process contains some quirks that cause the body to make antibodies to a wide variety of components in the vaccine. Diseases associated with the tissues to which autoantibodies are made include thyroiditis (which can lead to hypothyroidism in dogs), lupus, cardiomyopathy, and autoimmune hemolytic anemia.

Others IMHA/AIHA cases have begun during pregnancy, just after delivery, after the first “heat” and just after FRONTLINE® Flea and Tick Control or heartworm treatment.

Not all vets know how to treat this horrible disease


Dr. Leah Cohn

Mike Richards, DVM

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